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Ectopic pregnancy

The ectopic pregnancy occurs when the fertilized egg attaches itself outside the cavity of the uterus (womb). In most cases the ectopic pregnancies are found in the Fallopian tubes.

The ectopic pregnancy is not usually surviving and in most cases an embryo is not developed. Usually the ectopic pregnancy is interrupting the development at certain period (kind of miscarriage). The majority of women with ectopic pregnancy should be operated or treated with medication.

Ectopic pregnancy Risk Factors

  • advanced maternal age of 35 years or older;
  • history of pelvic surgery, abdominal surgery, or multiple abortions;
  • history of pelvic inflammatory disease;
  • history of endometriosis;
  • conception occurred despite tubal ligation or IUD;
  • conception aided by fertility drugs or procedures (IVF, GIFT, etc.);
  • smoking;
  • previous ectopic pregnancies;
  • history of sexually transmitted diseases.

Ectopic pregnancy symptoms

Ectopic pregnancy

Ectopic pregnancy

  • lower abdomen pain and/or
  • period delay and/or
  • bleeding from the vagina and/or
  • vaginal spotting and/or
  • positive pregnancy test and/or
  • dizziness or fainting (caused by blood loss) and/or
  • low blood pressure (also caused by blood loss).

At first the ectopic pregnancy develops like a normal pregnancy and the same symptoms such as nausea and tender breasts will be present. However, some women do not have these symptoms and do not suspect that they might be pregnant.

The vaginal bleeding can vary from being slight or brown vaginal discharge to being like a normal period.

If you are pregnant and have a long-lasting throbbing in one side of your lower abdomen or if you experience sudden pain you should contact your doctor. This is important because an ectopic pregnancy can be life-threatening if it ruptures and causes internal bleeding.

Ectopic Pregnancy Treatment

Once it is diagnosed, the ectopic pregnancy is treated right away to avoid rupture and severe blood loss. There are different types of treatment for ectopic pregnancy. The decision about which treatment to use depends on how early the pregnancy is detected and what are the same symptoms (pain, bleeding, blood loss, etc.).

Sometimes for very early ectopic pregnancy that is not causing bleeding, women could have a choice between using medicine or surgery to end the pregnancy.

Ectopic Pregnancy medication

Using methotrexate to end an ectopic pregnancy spares you from an incision and general anesthesia. But unfortunately this type of treatment could have several complications – it does cause side effects and can take several weeks of hormone blood-level testing to make sure that treatment has worked. Methotrexate is most likely to work in cases when the levels of pregnancy hormone (so called “human chorionic gonadotropin” – hCG) are low (less than 5,000). Methotrexate can be also effective during extopic pregnancy when the embryo has no heart activity.

Ectopic Pregnancy Surgery

During ectopic pregnancy with severe symptoms (pain, bleeding, dramatic blood loss or high hCG levels), surgery could be needed – even surgery could be the only solution.

Sometimes in developed clinics the modern endoscopic methods also could be effective – namely laparoscopic surgery that uses a small incision.

In most cases of ruptured ectopic pregnancy the emergency surgery is needed.

Expectant management

For an early ectopic pregnancy that appears to be naturally miscarrying (aborting) on its own, women could avoid any treatment. Just expectant management would be needed – regular hCG blood tests and ultrasound monitoring.

 


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